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ALIMENTARY TRACT AND METABOLISM › DRUGS FOR ACID RELATED DISORDERS › ANTACIDS › Combinations and complexes of aluminium, calcium and magnesium compounds
almagate
A02AD03
Forms & Strengths
- Oral Suspension: 500 mg/5 mL
- Chewable Tablets: 500 mg
- Chewable Tablets: 1.5 g
Adult Dosing
- Hyperacidity/Dyspepsia: 1 g to 1.5 g (two to three 500 mg tablets or 10-15 mL suspension) taken 30 to 60 minutes after meals or when symptoms occur
- Maximum Daily Dose: 8 g daily
Pediatric Dosing
- Children < 12 years: Safety and efficacy not well established; use generally not recommended unless directed by a physician
Indications
- Symptomatic relief of hyperacidity associated with gastritis, peptic ulcer disease, hiatal hernia, and heartburn
- Hyperphosphatemia in chronic renal failure (off-label as phosphate binder)
Mechanism of Action
- Antacid composed of aluminum and magnesium hydroxides in a hydrated aluminum magnesium silicate lattice
- Neutralizes gastric hydrochloric acid directly, raising gastric pH and reducing pepsin activity
- Provides a sustained buffering capacity and protective coating effect on the gastric mucosa
Contraindications
- Hypersensitivity to aluminum or magnesium compounds
- Severe renal impairment (creatinine clearance < 30 mL/min) due to risk of aluminum and magnesium accumulation/toxicity
- Hypophosphatemia
- Appendicitis or symptoms of gastrointestinal obstruction
Adverse Reactions
- Constipation (due to aluminum content)
- Diarrhea (due to magnesium content, often balances aluminum effect)
- Hypermagnesemia (in patients with renal insufficiency)
- Aluminum accumulation and osteomalacia or encephalopathy (with chronic high-dose use in renal impairment)
Drug Interactions
- Decreases absorption of acidic and chelation-sensitive drugs (e.g., fluoroquinolones, tetracyclines, iron salts, ketoconazole, thyroid hormones) by altering gastric pH and binding; separate administration by 2 hours
- Salicylates: Urinary alkalinization increases renal clearance and decreases serum concentrations of salicylates
- Enteric-coated preparations: Antacids may cause premature dissolution of enteric coatings, leading to gastric irritation
Curated Content: Needs Vetting Before Put to Clinical Use